ABSTRACT
Introduction: Foot Ulcer is the most frequent complicationof Diabetes Mellitus related to lower extremities with highmorbidity. Infection is an important component of foot ulcer.The present study was undertaken to study the clinical andmicrobiological profile of diabetic foot ulcer in a tertiary carecenter.Material and Methods: It is a prospective observational studywhich has been conducted at VIMSAR, Burla from November2017 to November 2019. Consecutive patients of Diabeticfoot ulcers were included in this study. After admissiondetailed history and biochemical investigations were donein all cases. Nerve Conduction study, doppler of lower limbwere performed to assess peripheral neuropathy and vasculardisease. The ulcers were graded according to Wagner’sstaging. Swabs were taken for culture and sensitivity.Results: Out of 1234 patients of DM admitted to the hospital,116 (9.4%) patients had foot ulcer. There were 87 (75.0%)males and 29 (25.0%) females with M:F ratio of 3:1. 95(81.9%) patients were from rural and 21 (18.1%) from urbanarea. Majority (n=44, 38.0%) of patients belonged to 51-60years of age and only 3 (2.0%) were within 21 to 30 years.Type-1 and -2 DM was found in 4 (3.0%) and 112 (97.0%)patients and the duration of DM was given. Grade-2 ulcerwas found in 62 (53.5%) cases. Risk factors like peripheralneuropathy, retinopathy and nephropathy were present in(n=65, 56.1%), 24 (20.7%) and 35 (30.1%) cases respectively.Early signs of ulcerative lesion like abundant callus, crackfoot, blistering was present in 28 (24.1%), 54 (46.6%),10(8.6%) cases respectively.Conclusion: This study showed that foot ulcer is a commonchronic complication of DM mostly found in elderly patientswith poor glycemic control from rural areas. S.aureus andP.aeruginosa are the common organisms detected from theulcer.
ABSTRACT
Aim:The aim of our study was to estimate the level of HbA1c in patients with Acute Coronary Syndrome (ACS). To determine any correlation between HbA1c, admission blood glucose (Random blood sugar), serum lipid profile among the cases and to evaluate the outcome during hospitalization. Study Design and Setting:Cohort study.Place and Duration of the Study:Department of Biochemistry and General Medicine including ICCU and Cardiology unit, RIMS, Imphal, between September 2015 to August 2017.Methodology:Data were collected from 98 patients admitted in Medicine ward who were diagnosed with ACS irrespective of their diabetes status and they were divided into three groups according to their HbA1c levels (<5.7%, 5.7-6.4%, > 6.5%). The blood samples collected by venipuncture were analyzed for HbA1c level, done by RANDOX HbA1c Rx series (latex agglutination inhibition assay), admission blood glucose (measured by Trinder’s method) and serum lipid profile (RANDOX enzymatic Endpoint Method Rx series). The data were analyzed using statistical tools like Chi Square test, Independent sample t test, Pearson’s Correlation, Fisher’s exact test through SPSS 21.0.Results:Majority of the patients were men (72.4%) & (27.6%) women and in the age group of 51-65 years. The mean ageis 62.14 years. 54.1% of the ACS patients were already diagnosed cases of type 2 diabetes mellitus whereas 45.9% were non-diabetic. Out of 98 patients, 60 had HbA1c level in the diabetic range (≥6.5%), 25 in the pre-diabetic range (5.7-6.4%) and the remaining 13 were within normal range (<5.7%). Admission blood glucose, total cholesterol and LDL were positively correlated with HbA1c value. Conclusion:The mortality of the ACS patients irrespective of diabetic status during hospitalization was associated with HbA1c value irrespective of diabetic status during hospitalization. However, it was not associated with thirty days mortality